Clinical research of allogeneic hematopoietic stem cell transplantation for relapsed or refractory lymphoma

Objective To explore the efficacy and safety in the treatment of relapsed or refractory lymphoma after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods The method of allo-HSCT was adopted to treat 7 patients with relapsed or refractory lymphoma from January 2007 to January 2012 in the General Hospital of Beijing Military.The primary disease included 6 cases of NHL and 1 case of HL.4 cases had one recurrence,2 cases had two or more relapses,and 1 case was primary refractory.The patients had an average age of 33.7 years old (ranging froml8 to 48-year-old) and included 4 males and 3 females.The patients included 2 cases of diffuse large B-cell (DLBCL) and 1 for each case of T lymphoblastoid cell type (T-LL),skin extranodal NK/T cell type (ENKTCL-N),hepatosplenic T-cell type (HSTCL),Burkitt' s type (BL),and HL mixed cell type.3 patients were in remission while 4 patients did not achieve remission at the time of transplantation.3 cases had donor and recipient HLA matching while the remaining 4 mismatched.Bone marrow and peripheral blood stem cell transplantation were used in this study.Patients were pretreated with fludarabine,melphalan,anti-human thymocyte globulin cyclosporin A (CsA) and methotrexate (MTX) to prevent graft-versus-host disease (GVHD).Toxicity,GVHD and disease-free survival were monitored in patients after transplantation.Results 6 patients tolerated conditioned regimen and achieved hematopoietic reconstitution.Implantation evidence testing confirmed 100 ％ hematopoietic from donors.Follow-up was up to January 2011 with a median of 29.6 months (1-70 months).The overall survival rate was 71.4 ％.5 patients had acute GVHD and 4 experienced chronic GVHD.1 patient died of infection and 1 died of relapse,and the rest patients were alive.The longest disease-free interval was up to 70 months.Conclusion allo-HSCT is effective and safe for relapsed or refractory lymphoma.It can be a key technology of extensive clinical use for treating relapsed or refractory lymphoma. Key words: Lymphoma, recurrence, refractory; Transplantation conditioning; Hematopoietic stem cell transplantation, allogeneic; Long-term survival; Graft vs host disease